SAMPLE STRATEGIES AND
EVIDENCE-BASED OR -INFORMED STRATEGY MEASURES
Compiled by the Strengthen the Evidence
for Maternal and Child Health Programs Initiative:
Strengthen the Evidence is a collaborative activity of the Women’s and Children’s Health Policy Center, the
Health Resources and Services Administration, Welch Medical Library at Johns Hopkins University, and the
Association of Maternal and Child Health Programs.
April 2016
April 2
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services
(HHS) under grant number U02MC28257, MCH Advanced Education Policy, $1.65 M. This information or content and conclusions are those of
the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S.
Government.
SAMPLE STRATEGIES AND ESMS
Strengthen the Evidence for MCH Programs Initiative
Domain and National
Performance Measure
Strategy [Source]
Evidence-based/-informed Strategy Measure
(ESM)
NPM 1: Percent of women with
a past year preventive medical
visit
Work with Medicaid to improve the process of auto-enrollment
into additional coverage after Medicaid coverage expires
postpartum [4]
Offer enabling services through community organizations to
facilitate access to preventive visits [3]
Medicaid extends automatic eligibility beyond
current state standard
Women/Maternal Health
NPM 2: Percent of cesarean
deliveries among low-risk first
births
Perinatal/Infant Health
NPM 3: Percent of very low birth
weight infants born in a hospital
with a Level III+ NICU
2
Host a webinar for providers about annual preventive visits and
strategies to address missed opportunities [4]
Convene task force comprised of agencies focused on women’s
health
Support quality improvement collaboratives for hospitals to
identify areas of improvement and learn from other hospitals
[3]
Use Medicaid data to inform programmatic efforts and review
economic costs of cesarean deliveries [3]
Extend targeted outreach to hospitals with high rates of
cesarean deliveries [3]
Develop and disseminate tools to educate hospitals on the
importance of instituting a hard-stop policy [3]
Support quality improvement collaboratives for hospitals
regarding high-risk maternal transports
Strengthen transportation systems for transport of high-risk
mothers and newborns
Develop educational model for identifying indications for
transport of high-risk pregnant women
Strengthen communication networks between Level III and
other birth facilities in accordance with ACOG Consensus
Statement
% of community health centers and family planning
clinics agencies offering language and translation
services
# of participants attending webinar
# of task force meetings in past year
% of total birth hospitals participating in
collaborative
Annual report profiling deliveries by type, risk
factors, and cost
% of hospitals with high rates of cesarean deliveries
that receive site visits
# of providers who complete CME module about
non-medically indicated deliveries prior to 39 weeks
# of hospitals participating in collaboratives
Each birth facility has a point of contact for transport
# of providers who complete CME module
% of hospitals whose high-risk committees attend
periodic conference calls to review protocols and
outcomes for delivery of VLBW infants
April 2016
SAMPLE STRATEGIES AND ESMS
Strengthen the Evidence for MCH Programs Initiative
Domain and National
Performance Measure
NPM 4: A. Percent of infants
who are ever breastfed and B.
Percent of infants breastfed
exclusively through 6 months
NPM 5: Percent of infants placed
to sleep on their back
Strategy [Source]
Maintain a 24-hour breastfeeding hotline staffed by a bilingual
certified lactation consultant [4]
Deliver training and support for home visitors [3,4]
Offer technical assistance and education to employers using the
Business Case for Breastfeeding [3]
Continue to strengthen hospital efforts in supporting
mothers/babies through comprehensive breastfeeding policies
[3,4]
Analyze PRAMS and SUID-CDR data to identify program targets,
inform interventions, and develop fact sheets [1,2]
Partner with WIC, home visiting or other programs to provide
safe sleep education and counseling [1,2]
Enforce laws regarding mandatory training for childcare
providers, medical professionals, and emergency medical
technicians [1,2]
Implement train the trainer programs for the various providers
engaged pre and postnatally [1,2]
Child Health and/or Adolescent Health
NPM 6: Percent of children, ages
10 through 71 months, receiving
a developmental screening using
a parent-completed screening
tool
3
Implement a quality improvement learning collaborative to
improve developmental screening practices (e.g. tools,
documentation, referrals) [3,4]
Establish an interagency committee for developmental
screening to facilitate communication [3]
Develop a shared data collection tool to track information on
screening and follow-up [3]
Support Help Me Grow activities to make developmental
screening tools accessible to families [3]
Evidence-based/-informed Strategy Measure
(ESM)
Hotline available
Increase knowledge of best practices among home
visitors as assessed at annual cross-model training
# of employers who receive technical assistance and
education about best breastfeeding practices
# of hospitals receiving technical assistance in
comprehensive breastfeeding policies
# of state-wide or local programs integrating
PRAMS/SUID data to develop or target interventions
#/% of WIC participants, home visiting clients, or
other program participants that received safe sleep
counseling
% of audited child care providers or other
professionals in compliance with regulation
% of licensed medical professionals who received CE
credits on SUID prevention or safe sleep practices in
the past year
# of pediatric and family practices participating in
learning collaborative
Interagency committee established
Statewide registry made available to all trained
providers
Funding secured for Help Me Grow
April 2016
SAMPLE STRATEGIES AND ESMS
Strengthen the Evidence for MCH Programs Initiative
Domain and National
Performance Measure
NPM 7: Rate of hospitalization
for non-fatal injury per 100,000
children ages 0 through 9 and
adolescents ages 10 through 19
NPM 8: Percent of children ages
6 through 11 and adolescents
ages 12 through 17 who are
physically active at least 60
minutes per day
Strategy [Source]
Provide training for home visitors on assessing home safety [3]
Link with schools to promote safe behaviors through
comprehensive parent/student education campaigns [3]
Support local health departments in offering free car seat
safety inspections and distributing care seats [3,4]
Encourage school districts to require helmet use when riding to
school [3]
Analyze School Health Policies and Practices Study data [2]
Partner with the department of education to design and
implement school-based physical activity programs at the state
or district level [2]
Provide training for pediatricians to screen for
overweight/obesity and counsel/refer children for behavioral
intervention [2]
Leverage funding to communities to focus on enhancing urban
design [3,4]
Evidence-based/-informed Strategy Measure
(ESM)
Increase knowledge of best practices among home
visitors as assessed at annual cross-model training
% of middle schools implementing evidence-based
# of inspections completed and car seats distributed
in past year by health department
% of schools with policies requiring helmet use
#/% of districts or schools identified as lacking
recess, PE periods, or after-school programs that
receive targeted outreach
#/% of schools that participate in state or districtlevel intervention to improve physical activity
content in PE classes
% of licensed pediatricians who receive CME credits
on BMI screening and behavioral counseling in the
past year
Secure additional funding from multiple sources to
enhance urban design
Adolescent Health
NPM 9: Percent of adolescents,
12 through 17, who are bullied
or who bully others
NPM 10: Percent of adolescents,
ages 12 through 17, with a
4
Obtain data on the current bullying prevention efforts being
implemented in schools [3,4]
Convene a taskforce comprised of community leaders
(including parents) to coordinate efforts [4]
Offer technical assistance to front line professionals bullying
prevention and response [3,4]
Facilitate dissemination and enforcement of relevant state laws
and policies [4]
Implement provider reminder systems to promote visits and
alert providers when adolescents miss appointments [3]
Environmental landscape completed
# of times met over past year
# of professionals who receive technical assistance
Monitoring system established
#/% of practices that have implemented a practicewide reminder system
April 2016
SAMPLE STRATEGIES AND ESMS
Strengthen the Evidence for MCH Programs Initiative
Domain and National
Performance Measure
preventive medical visit in the
past year
Strategy [Source]
Make resources available for providers on topics such as
encouraging adherence to Bright Futures visit content and
periodicity schedules, awareness of free preventive health
services covered under Medicaid [3,4]
Partner with school-based health centers to promote and
incentivize adolescent health services [3,4]
Provide adequate financing and reimbursement for preventive
care [3]
Children and Youth with Special Healthcare Needs (CYSHCN)
NPM 11: Percent of children
with/without special healthcare
needs having a medical home
NPM 12: Percent of adolescents
with and without special health
care needs who received
services necessary to make
transitions to adult health care
5
Evidence-based/-informed Strategy Measure
(ESM)
# of providers offered resources about Bright
Futures preventive services covered
#/% of schools that participate in programs to
increase the rate of adolescent well-visits (e.g.
movie ticket incentives, “back-to school”
promotions)
Financing and reimbursement policies established to
provide adequate support for preventive care visits
Support practices with technical assistance to develop and
implement family engagement policies [3]
# of providers and facilities receiving technical
assistance about family engagement
Incentivize practices for participating in QI activities that
actively engage patients [3]
With input from family representatives, create a practice-wide,
comprehensive plan of care template that can be used across
systems of care for CYSHCN [4]
Conduct outreach to families about availability and benefits of
the medical home [3]
Partner with AAP, AFP, ACP, and AANP chapters to facilitate the
dissemination of evidence-informed transition resources [3]
Increase the number of QI initiatives involving pediatric and
adult practices as well as parents and young adults [3,4]
Encourage use of an evidence-based health care transition tool
for transition readiness assessment [4]
Work with Medicaid’s EPSDT program to educate pediatric
providers on incorporating readiness assessments into
adolescent well visits [4]
Policies and programs established to incentivize
practices for actively engaging patients
#/% of practices that use a comprehensive plan of
care template
% of communities that conducted outreach about
the availability and benefits of the medical home
# of professional organizations for which
partnerships have been established
# of QI initiatives created in the past year
# of facilities using a evidence-based health care
transition tool for transition readiness assessments
# of Medicaid EPSDT providers that have
incorporated readiness assessments into adolescent
well visits
April 2016
SAMPLE STRATEGIES AND ESMS
Strengthen the Evidence for MCH Programs Initiative
Domain and National
Performance Measure
Strategy [Source]
Evidence-based/-informed Strategy Measure
(ESM)
NPM 13: A. Percent of women
who had a dental visit during
pregnancy and B. Percent of
children, ages 1 through 17, who
had a preventive dental visit in
the past year
Improve data collection and reporting about dental visits and
referrals [4]
Include preventive dental services for pregnant women as a nocost preventive service within the Essential Health Benefit
package [3]
Form interagency partnerships to improve coordination
between services [3,4]
Increase oral health awareness by distributing educational
material in community-based settings [3,4]
Promote increased use of state-funded quitline [3]
Implement smoking cessation programs such as Baby & Me
Tobacco Free Program and Smoking Cessation and Reduction in
Pregnancy Treatment (SCRIPT) Program in local jurisdictions [4]
Annual report including utilization of oral health
services presented to state legislature
Preventive dental services implemented as a no-cost
preventive service within the Essential Health
Benefit package
# of interagency partnerships implemented to
coordinate dental and other services
# of community-based organizations provided with
oral health educational materials
# of calls received by smoking quitline in the past
year
#/% of local communities with tobacco control laws
and ordinances
#/% of WIC sites implementing referral of pregnant
and postpartum women to smoking cessation
services
# of local jurisdictions with a formal smoking
cessation program for pregnant and postpartum
women
Support workforce development trainings for Title V staff to
ensure knowledge of insurance coverage [3,4]
Modify public insurance benefits to reduce Medicaid churning
[3]
Expand CHIP eligibility [3,4]
Offer insurance application assistance through community
organizations [3]
# of staff who complete trainings about insurance
coverage for children
Temporary eligibility criteria established to reduce
loss of insurance benefit for families
Expanded eligibility criteria for CHIP implemented
#/% of community organizations that offer
assistance with insurance applications
Cross-Cutting/Life Course
NPM 14: A. Percent of women
who smoke during pregnancy
and B. Percent of children who
live in households where
someone smokes
NPM 15: Percent of children
ages 0 through 17 who are
adequately insured
6
Increase the number of local communities with tobacco control
laws and ordinances [3,4]
Partner with WIC to promote smoking cessation among
pregnant and postpartum women [3,4]
April 2016
SAMPLE STRATEGIES AND ESMS
Strengthen the Evidence for MCH Programs Initiative
Sources of Strategies:
[1] Kogan et al. (2015). A new performance measurement system for maternal and child health in the United States. Maternal and Child Health Journal.
Retrieved from http://dx.doi.org/10.1007/s10995-015-1739-5
[2] Kogan, M., & Lawler, M. (2015, December 8). Development of evidence-based or informed strategy measures [Webinar]. Retrieved from
http://www.amchp.org/Calendar/Webinars/Documents/MCHB%20ESM%20webinar.pdf
[3] Women’s and Children’s Health Policy Center, Johns Hopkins Bloomberg School of Public Health. Environmental Scans. Retrieved from
http://semch.org/environmental-scans.html
[4] Association of Maternal and Child Health Programs & Johns Hopkins Bloomberg School of Public Health. Taking Action with Evidence: Implementation
Roadmap Webinars. Retrieved from http://www.amchp.org/AboutTitleV/Resources/Pages/State-Action-Plan.aspx
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April 2016